vaping and disease risks - honeyhole... · 12/11/2019 · e-liquids and aerosols contain toxic...

Vaping and Disease Risks

Cynthia Grondin, PhDComparative Toxicogenomics Database

North Carolina State University11/12/2019

e-liquid

mouthpiece

on/off switch

Lithium battery

atomizer

Vape mods

aerosol/vapor

Cynthia J Grondin, PhDIlluminating how chemicals affect human health

Comparative Toxicogenomics Database

common e-cigarette vaping devices



Juuls – “Juuling”

1 pod = nicotine in entire pack of cigarettes

ALL Juuls contain NICOTINE



Anatomy of a Juul

mouthpiece

chimney

gold plated contact

coil, wick

indicator

e-liquid

battery

e-vapor



Beyond the List of Ingredients

nicotinepropylene glycolglycerinbenzoic acidflavorings, oils

Juul chemicals



biotransformation of nicotine into other compounds

Pharmacological Reviews 57(1):79–115




conversion of propylene glycol into acetaldehyde and formaldehyde (carcinogens)

Environ Sci Technol 50(17):9644-9651

Juul chemicals



conversion of glycerin into acrolein (carcinogen)



Environ Sci Technol 50(17):9644-9651

Juul chemicals



glycerol

propylene glycol



PLoS ONE 12(3):e0173055

benzoic acid can transform into benzene (carcinogen)Juul chemicals



1-hexanol cyclotene limonene

2,3-pentanedione decan-4-olide linalool

2,5-dimethylpyrazine decanaldehyde linalyl acetate

2,6-lutidine Diacetyl maltol

2-acetylpyrrole diethyl succinate Menthol

3,4-dihydrocoumarin ethyl acetoacetate menthone

3-hexen-1-ol ethyl hexanoate methyl acetate

4-Butyrolactone ethyl lactate methyl cinnamate

5-methyl-2-furfural ethyl maltol methyl salicylate

acetoin Ethyl Salicylate methylheptenone

alpha-terpineol ethyl vanillin Nicotine

anisyl acetate Eucalyptol n-pentanol

benzaldehyde Eugenol Pulegone

benzyl acetate Furaldehyde pyridine

Benzyl Alcohol furaneol raspberry ketone

Camphor furfuryl alcohol tetramethylpyrazine

Cinnamaldehyde gamma-valerolactone vanillin

citronellol isoamyl acetate

Alien Blood Double Apple Hookah Oatmeal Cookie

Bad Apple Energy Drink Orange Mint

Bluewater Punch Grape Hookah Peach Schnapps

Carmel Popcorn Iced Berry Pina Colada

Cherry Lava Java Jolt Pomegranate

CooCoo Coconut Just Guava Snap!

Cotton Candy Kick! Tutti Frutti

Cupcake Menthol Vanilla Bean

flavorings may contain many other chemicals such as Diacetyl(shown to cause Popcorn Lung)



Juul chemicals


Universal System for Analysis of Vaping (U-SAV) machine

What chemicals are in e-liquids and aerosols?

Int J Environ Res Public Health 14(10): 1225

chemicals are measured in e-liquids, aerosols, urine, blood, saliva



Vaping is NOT just inhaling flavored water vapor

PLoS One. 2013;8(3):e57987



Metals contaminate e-liquids and aerosols

Environ Health Perspect. 2018 Feb 21;126(2):027010



propylene glycol

glycerol

benzoic acid

glycerin

benzeneacrolein

glycidol

propionaldehyde

1-hexanol

anisyl acetategamma-valerolactone

5-methyl-2-furfural

4-butyrolactone

acetoin

decanaldehyde

methylheptanone

maltol

Eugenolethyl acetoacetate

2,3-pentanedionedecanaldehyde

furaldehyde

limonene

benzyl acetate

Menthol

cyclotene

Diacetyl

vanillin

1-hexanol3,4-dihydrocourmarin

methyl salicylate

Pulegone

camphor

alpha-terpineol

3-hexen-1-ol

pyridine

2-acetylpyrrole

2,6-lutidine

Nicotine

Free Radicals

methylglyoxal

2-butenal

Particulate Matter

Acetone Acetaldehyde

Formaldehyde

Aluminum

Nickel

Lead

ZincManganese

Tin

Chromium

Copper

Iron



Vaping aerosols contain MANY chemicalsmany more than shown here

Diseases

Chemicals

Genes

GO &

Phenotype

Comparative Toxicogenomics

Database (CTD)

Integrate data

Exposures

Pathways

ctdbase.org

• >43 million

toxicogenomic

relationships

• updated monthly

Cellular locationMolecular functionBiological processes

PhD-level scientists

read studies

Health Effects of Chemicals



ctdbase.org

Chemicals Diseasesdirect



ctdbase.org

Chemicals Diseases

Genes

inferred



Nicotine (Protonated) vs Nicotine (Free base) vs Salts

Nic[H+] Nic

• acidic environment low pH• protonated• does not cross membranes

rapidly• less potent• deposits in respiratory tract

~50% efficiency• tobacco smoke • ~ 12mg/cigarette

• deprotonated/free base• more volatile• more potent• harsher throat hit• increased sensory effects• rapidly deposits in mouth,

respiratory tract• e-cigarettes• ~0-24 mg/ml

Nicotine Salts

• nicotine benzoate• nicotine levulinate• nicotine pyruvate• rapid absorption

• JUULs• smoother throat hit

• allows higher nicotine

• ~60 mg/ml

flavors can affect pH of e-liquids and consequently, nicotine form

+

-



Effects of Nicotine in e-cigarette aerosol

interacts with 1,128 unique genes

Nicotine

involved in 2,656 gene interactions

involved in 631 molecular pathways

associated with 934 phenotypes

directly related to 224 diseases

inferred relationship to 1,837 diseases

Cynthia J Grondin, PhD 11/12/2019Illuminating how chemicals affect human health


Nicotine Effects on HealthNicotine-DiseasesNicotine-Disease Categories

• Cardiovascular Disease• Respiratory Tract Diseases• Reproductive Disorders• Depression• Lung Cancer• Colon Cancer• Type 2 Diabetes• Pulmonary Fibrosis• Pancreatic Cancer• Heart Attack• Nerve Degeneration• Atherosclerosis• Stroke• Metastasis• Acute Kidney Injury• Hypertension• Panic Disorder

224 direct/1837 inferred disease relationships



Chemical-Disease Associations in CTD

Input chemicals in e-liquids/aerosols

Search for disease associations



Chemicals in Juul pods and aerosols

• Nervous System • Cardiovascular • Respiratory Tract

• Cancer• Immune System• Mental Disorders

Top Disease Categories



Vaping-Related Illness aired on GMA 9/3/2019





Number of Lung Injury Cases Reported to CDC as of November 5, 2019

Centers for Disease Control Updates

November 8, 2019

• 2,051 vaping-related illnesses across 49 states

• 39 confirmed deaths related to vaping, in 24 states

• more deaths under investigation

• chemical of concern vitamin E acetate

October 15, 2019 (867 patients)

• 86% reported vaping THC (34% THC exclusively)

• 64% reported vaping nicotine (11% nicotine exclusively)



Scientific Study on Vaping Cannabis

• cannabis smoke contains many of the same carcinogens found in

tobacco smoke

• average particle concentrations of 200-600 ug/m3, peak concentrations

1600 mg/m 3

• equivalent to extreme air pollution (wildfires and severe industrial

pollution)

• can cause cardiovascular and respiratory disease



Measuring Aerosol Particulate Emissions from Cannabis Vaporization and Dabbing

Jacques PA, Zalay M, Huang A, Jee K, Schick S [email protected]

Vaping THC - Concerns

1) Pesticides and Solvents

i. pesticides and fungicides used to grow cannabis

ii. concentration solvents (butane, hexane, isobutene, isopropyl alcohol)

2) Flavorings added to cannabis products

i. Diacetyl, 2,3-Pentanedione, Acetoin

3) Cutting agents

i. Vitamin E acetate

Borodovsky JT. Addiction http://doi.org/10.1111.add.14855



Vitamin E Analogues



I II III

functional group

signalingdomain

hydrophobic domain

a-Tocopheryl Acetate

Br J Cancer. 2003. 88: 1948-1955

THC Effects on HealthTHC-Disease AssociationsTHC-Disease Categories• Substance-related Disorders• Nerve Degeneration• Morphine Dependence• Bipolar disorder• Marijuana Abuse• Acute Kidney Injury• Anxiety Disorders• Hypotension• Cognition Disorders• Opioid Disorders• Pregnancy Complications• Movement Disorders• Memory Disorders• Learning Disorders• Tachycardia• Catalepsy• Pulmonary Edema

87 direct/2874 inferred disease relationships



e-cig vapor S. mutans

Kim et al. PLoS One 2018 Sept 7

Vaping Effects on Teeth



More Immediate Effects?

Nicotine is HIGHLY addictive

Increases likelihood of smoking cigarettes



Acrolein, nicotine and other vaping chemicals may contribute to a hardening of the arteries and limit cardiovascular fitness

Effects on Cardiovascular Fitness:




Effects on Mental Health:Adolescent e-cigarette users show increased Depression, Panic Disorder and inability to experience pleasure vs. non-users


Vaping associated with illicit drug use, mental health problems and impulsivity in university students

Leventhal AM et al. J Psychiatr Res. 2016 FebGrant JE et al. Ann Clin Psychiatry 2019 Feb



Effects on Sexual Health:

Nicotine can significantly decrease physiological sexual arousal in healthy nonsmoking men and women (18-22 years)


J Sex Med. 2008 Jan;5(1):110-21J Sex Med. 2008 May; 5(5):1184-1197



Chen et al., J Expo Sci Environ Epidemiol. 2017 Dec 29



Second-hand and Third-hand Vape

Vaping Affects Users Differently

• type of device

• e-liquid

• vaping patterns

• coil resistance, age, composition

• user age, weight, metabolism, health,

genetics

• environmental factors



Combustible vs. E-cigarettes

Both increase risks of adverse health outcomes

Both expose users to toxic chemicals (smoke and e-vapor)

Vaping increases risk of smoking tobacco cigarettes

Exposure to toxic substances from combustible tobacco cigarettes may be greater than from e-cigarettes

Exposure to metals (e.g., lead, nickel, chromium) may be greater in e-cigarette vapor than tobacco cigarettes

Both are addictive



E-liquids AND aerosols contain toxic chemicals

Vaping chemicals can cause DNA damage

Vaping impacts genes, pathways, immune system

Vaping negatively impacts physical and mental health

Vaping increases risk of thousands of diseases

Take Home Points



The New Look of Nicotine Addiction (Massachusetts Tobacco Cessation & Prevention Program)

– www.GetOutraged.org

Surgeon General: E-Cigarettes & Young People– www.e-cigarettes.surgeongeneral.gov/

Centers for Disease Control: Electronic Cigarettes– https://www.cdc.gov/tobacco/basic_information/e-

cigarettes/index.htm

Educate Yourself

Resources for HELP



http://www.getoutraged.org/

http://www.e-cigarettes.surgeongeneral.gov/

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm

.ORG



vaping and disease risks - honeyhole... · 12/11/2019 · e-liquids and aerosols contain toxic...

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